Shawn was born in August of 1972 in Santa Fe, New Mexico. I had a short labor and a fairly untraumatic birth — as much as can be expected in a hospital. I had natural childbirth and an unnecessary 3rd degree episiotomy. Shawn weighed 8 lbs. 6 oz. and was 21 inches long. I remember looking at his penis and thinking how strange it looked. (I’d never seen an uncircumcised baby before.) It took me two days to get up the courage to ask the nurse if my baby was “OK” and if his penis was “normal.” She laughed and assured me they all looked that way and that he’d look “normal” after he was circumcised. I repeatedly asked the doctor if it would hurt Shawn and he repeatedly said “no,” and that “it was better to do it now when it will heal quickly.” So I signed the paper to have it done.
On the third day after his birth I decided to take a look at Shawn in the nursery. As I walked down the hall I heard him screaming. I rushed to the nursery and knocked on the window. The nurse came to the door and I asked where he was. She said “He’s across the hall being circumcised.” The next few minutes were a living hell, an eternity of torture as I listened to him scream as I have never heard anyone scream before or since. I wanted to burst through the door and say “Stop! Stop!” But I didn’t know what they were doing or how long it would take. Finally the doctor came out. “Is he all right?!” I asked in panic. “You have a very strong little boy there,” he said. “It took three nurses to hold him down. He did not like what we did to him at all, but he’ll be fine.”
A nurse brought him to me and I took him to my room. I told him I was sorry and that I didn’t know it would hurt him so badly. He nursed and fell asleep. We went home from the hospital the next day. He healed and I didn’t think much about it again.
Then a year and a half later, when Shawn was 19 months old, the real problems began. Shawn awakened screaming in his bed!! He flung himself and thrashed and screamed and repeatedly was brought to a position of a crucifix as if someone was holding him down. I could not wake or comfort him. He screamed for 45 minutes and then fell back to sleep. I was horrified. I had never experienced anything like this before. The next morning he did not remember anything.
He went through this same thing about once a week for two years. Times varied from 30 minutes to 1 1/2 hours, but always the same high-pitched screaming, thrashing, and as he became older and more verbal he began saying, “No, no, no!!”, holding his genitals, and then as if someone was holding him down, he would fling himself into the circumcision position and struggle there. Then he’d break loose of the imaginary hold, grab his penis, and scream “No, no, no!!” again. Back and forth he would go until he’d finally give up and go to sleep. He wouldn’t let us comfort him. After a while we found that if he needed to urinate the screaming would last longer and if we could get him to go to the bathroom he’d usually fall asleep after that.
He started doing it about once a month when he was 3 1/2. Since he was 5 he has only done it about two times a year. He still does not consciously know he has ever done this. We have told him about it in detail and he cannot remember having these experiences. He does have nightmares occasionally and he will remember these the next day. We can awaken him after a bad dream and comfort him. This other thing that he does is not dreaming.
When Shawn was 2½ I spoke with Arthur Janov at a Birth/Rebirth Conference in Santa Cruz, Calif. I described Shawn’s behavior to him. He agreed that it was a typical circumcision trauma. He said to let him scream it out, to comfort him as much as one could, but not to worry, he would outgrow it.
When our second son, Peter, was born in 1979, my husband Jim and I had a hearty discussion about whether or not to have him circumcised. Jim felt concern that Peter wouldn’t “match” him and Shawn. I couldn’t believe that after all we’d been through, he’d even consider it! So I got out articles pro and con — O.B. texts, pediatric books, Mothering Magazine articles — for him to read. I told him that after he knew as much about it as I did I would then discuss it and if he still wanted to get it done I would agree. He never mentioned the subject again. Peter is still intact. I think men have a very difficult time dealing with this whether they admit it or not.
Vicki Campbell, Las Cruces, N.M.
One Man’s Story
I was born in a hospital in Colorado and was circumcised there. Because my mother left the hospital the day after I was born, I must have been circumcised within 24 hours of being born. My mother tells me that I was an unusual baby because I slept so frequently. I fell asleep instantly whenever she changed my diaper or whenever she placed me in bath water. Believing that there was something wrong with me, my mother took me to her doctor. He gave me a clean bill of health. I believe that this was a conditioned response to circumcision trauma.
I grew up on a farm and while I was a pre-schooler we had a cow which provided milk for our family. When I was three years old, my mother purchased a cream separator from an older couple. I recall that they were very friendly and that they doted on me when we went to pick up the cream separator. The separator consisted of two pieces of machinery that I remember vividly: a black cast iron apparatus in the shape of a goose neck and a stainless steel basin. The night after we purchased it I had a nightmare. I had the same nightmare again and again for several weeks. In my dream I am strapped to a black table, unable to move. I am naked. Between my legs, the black gooseneck apparatus of the cream separator is clamped to the edge of the table. To my right is a shiny, steel basin. The old woman who sold us the cream separator looms over my face. She smiles and tweaks my cheeks. I remember her big teeth. Behind her is her husband. He has a knife in his hand. He slices off part of my penis. He is emotionless. I do not feel pain, but anger, nausea and powerlessness. I am especially angry with the woman. How can she be smiling while I am being butchered? I try to kick away the knife, but I cannot. I am simply incapable of making my muscles do what I want them to do. I wake up feeling nauseous. This is the earliest dream I can recall, and the picture remains vivid in my mind to this day.
I am told that our dreams are merely our brains’ attempt to make sense of random electrical impulses. I am also told that infants cannot truly see anything because their eyes are unable to focus immediately after birth. However, I cannot get over the striking resemblance between a Gomco clamp and the black gooseneck of my mother’s cream separator. And why does the stainless steel basin — ever-present at all circumcisions — fit so prominently into my dream? I believe that my circumcision produced an electrical pattern in my brain that was something less than random, a template of sorts waiting for the right environmental objects to give it shape.
I believe that if parents are present during the circumcision of their son, they should not be within his sight. I do not believe that the presence of parents would be comforting or reassuring to the baby. He might believe, instead, that his parents are responsible for the act. He cannot understand their words or accurately interpret their facial expressions or gestures. In my dream, I believe that the smiling woman who distracts me and tweaks my cheeks is responsible for my being butchered. The message is confusing and not to be trusted.
I do not blame my parents for what happened to me. I believe that they chose to have me circumcised thinking that they were doing something good for me. My father was not circumcised. Perhaps he believed he was giving me an advantage he didn’t have. I believe that I did have some problems identifying with my father because we were different.
It is ironic that today one of the arguments for circumcision is that the boys, if left intact, might have trouble identifying with their circumcised fathers. Why didn’t physicians think of that in the ‘fifties, ‘forties and ‘thirties (when most fathers were not circumcised)? With the practice originating so recently, the identification problem must have occurred in every family at one time or another.
(Name and address withheld by request)
Dr. Justin Call, M.D., Psychoanalyst, Pediatrician, Child Psychiatrist, Professor in Chief of Child and Adolescent Psychiatry, School of Medicine, University of California, Irvine:
Dr. Call: As a pediatrician and as an intern in a hospital I used to do circumcisions. I was taught that the best time to do a circumcision was right at birth in the delivery room. It was a matter of convenience.
Rosemary: Why has neonatal circumcision become a routine procedure in U.S. hospitals?
C: Nobody can tell you what the scientific indications are for circumcision. With armies traveling in a desert, if the males are circumcised, they have fewer infections and swellings of the foreskin than individuals who have not been circumcised. This is under unhygienic, hot conditions. The other reason is the religious ritual.
R: What do you think about pain and trauma experienced by the infant during circumcision?
C: If you ask the question “Does the baby feel pain?” You bet he feels pain!! The helpless, panicky cry of an infant when circumcised is an abnormal kind of cry. It is a breathless, high-pitched cry that is never heard in other normally occurring circumstances. Then sometimes babies who are being circumcised do exactly the opposite. They lapse into a semi-coma. Both of these states, helpless crying and semi-coma are abnormal states in the newborn.
R: The semi-coma state must explain why some babies don’t cry while being circumcised. This makes people assume that it didn’t hurt the baby.
C: That’s right. Also people don’t distinguish between that high-pitched, panicky, breathless cry and a normal loud cry. And people don’t make the distinction between sleep and semi-coma. A very interesting study was done by Dr. Robert Emde and Dr. David Metcalf (et al)* at the University of Colorado Medical Center. They studied the sleep-wakefulness cycles of infants in relation to circumcision. They found that in the 24 hours following circumcision, a great deal more time was spent by the infant in a state of subdued sleep … withdrawal. This is the opposite of what people would expect.
R: What about using anesthesia for circumcising babies?
C: Administering anesthesia to a child is a risky procedure. Doctors would love not to use it if they could get away with it. Also they prefer not to use a local anesthetic because it swells the tissues. They can get a better closure of the tissues if they’re not swollen.
The rationale for circumcision that some doctors give is phimosis. This means that the foreskin cannot be drawn back beyond the edge of the glans. This is uncommon in the naturally occurring event when one does nothing about the foreskin. Phimosis** is normal in the newborn. The foreskin will naturally loosen and become easily drawn back by the time the child is a few years old. The operation of clipping the skin under the tongue to correct “tongue tie” used to be a popular procedure. Many doctors thought that the tongue should be able to protrude fully beyond the mouth. It has now been shown that the tongue lies in the mouth cavity and does not protrude in the newborn, but normally as the child grows older it will come out. That operation is rarely done any more.
R: I have interviewed a mother whose son was circumcised at age three. She said that his foreskin had started to grow back over the head of his penis so that he was having difficulty urinating. I wonder if his case could have been treated differently.
C: Usually phimosis can be treated successfully without circumcision or surgery of any kind. I don’t know the child’s circumstances.
I don’t recommend that any attention be paid to the foreskin until it loosens easily. After that the mother should draw it back occasionally to clean it. I have known that some mothers develop an obsession … a highly exciting sexual ritual around the drawing back of the baby’s foreskin several times a day. So it can definitely be overdone!
R: Apart from the immediate painful effects, how do you think the trauma of circumcision affects the individual throughout his life?
C: Some people have thought that circumcision is the first real castration and subsequent castration anxiety borrows some of its power from the earlier experience with circumcision. I don’t know if that theory has any validity.
But in the immediate newborn period, I believe that circumcision has a disruptive effect on the development of the mother-infant bond, because of the changes in the state of the infant. This interferes with the mother-infant bond just as medication would. The bond has been disrupted.
*Emde, Robert N., M.D.; Harmon, Robert J., M.D.; Metcalf, David, M.D.; Koenig, Kenneth L., M.D.; and Wagonfeld, Samuel, M.D. “Stress and Neonatal Sleep” Psychosomatic Medicine, Vol. 33, No. 6, Nov.-Dec. 1971, p. 491-497.
** Phimosis” is actually an incorrect term for the normally tight, adherent foreskin of the newborn. “Phimosis” should only be applied to the abnormally tight or adherent foreskin of an older individual.
(Tonya is the president and founder of the Association for Childbirth at Home, International, Los Angeles, CA. She worked on her Ph.D. in psychology with research done in early developmental psychology and development of infants. She is a lay midwife, and the mother of six children, five of whom were born at home. Four of her children are intact sons.)
Tonya: I have assisted with nine circumcisions of infant sons of parents whose births I had attended. The doctor believed that babies did better if someone was holding them. I had to lean over them and hold their legs prone. It took my whole body to hold down a newborn for circumcision.
Rosemary: It must have been hard for you to watch.
T: Yes. I hated to watch the babies cry. But the hardest thing for me was to watch parents who did not seem to want it done. Twice I’ve watched the mothers cry. In one case the mother did not want her baby circumcised, but her husband did. It was extremely unfortunate that she who was taking the responsibility for it questioned the decision, and he, who wanted it done, wasn’t even there. I have rarely seen a mother who wanted circumcision.
My feeling against circumcision is that it is the child’s body and you have to grant every person a “beingness.”
R: Would you say that your experiences with circumcisions have been quite traumatic?
T: I was bothered intellectually by it. But I’ve watched parents become traumatized. My concern is that babies have undifferentiated pain responses. They feel pain all over their bodies. I think it is more traumatic for babies to be circumcised within a few hours after birth. If you watch babies who have had easy births, their faces don’t look like they’re pained. Babies who have had difficult births … you can tell by looking at them that they have been in pain. If you take a traumatized baby and subject him to circumcision, you’re more likely to get a problem. You should at least wait until the baby has had a chance to be loved and calmed down before having a circumcision. Just because a baby has less differentiated pain response does not mean that it is less traumatic for him than it would be for someone older. It just seems less traumatic to adults because they don’t cry as long.
“The hardest thing for me was to watch parents who did not seem to want it done. Twice I’ve watched the mothers cry. I have rarely seen a mother who wanted circumcision.”
R: Sometimes when babies are circumcised they really scream. Other times they don’t make much noise. I wonder now if they retreat into themselves following a traumatic birth and are unable to cry out when they are circumcised.
T: When a person is injured, he can react in one of two ways. He can yell! This is a more pro-survival response than the kind of injury in which the person is so traumatized that he can’t cry out. Have you ever closed your hand in a car door and it hurt so badly that you couldn’t yell?! In four of the nine circumcisions that I have seen, the baby didn’t cry. He just seemed to be suddenly in a state of shock! That’s always easier on the parents because we expect crying to be a measure of pain.
R: We have had baby goats dis-budded with the cauterizing iron burning the horn bud out of the animal’s skull. Our friends who do this have observed that if the animal is a pet, if it has gotten a lot of loving from humans, then it will scream when it is being dis-budded. But if it has not been a pet, it will just stand there and take it. I find that intriguing.
T: To be able to cry out is better. What you describe doesn’t mean that it’s less traumatic for the goats who haven’t been loved, it’s more. The pet goats are more able to communicate pain. So that may explain why some babies don’t cry in response to being circumcised. I have seen babies so socked into it that they’ve been almost unconscious. I would feel more comfortable about a baby that cried than one who didn’t. It’s harder on the parents because screaming drives home the fact that the child has been injured, but the response is healthier for the child.
R: Some babies start to scream as soon as they are strapped to the circumcision board. Some babies scream when they’re just being examined. So sometimes trauma is not connected to pain at all, but being held down and invaded and “messed with.”
T: A baby that has just been born has gone from a warm, enclosed environment out into the cold, with bright lights, and they’re put on a table and stretched out. That’s traumatic. It’s an assault on his person. That’s one of the reasons I want parents to control births, so they can pick that baby up in their arms and not have anyone else mess with their baby.
R: What do you believe about the lasting effect of circumcision trauma?
T: I believe that trauma has a cumulative effect. I would like to keep my children from having as many injuries as possible. I guess it is very individualistic. Trauma during infancy may cause a child to be less responsive and more introspective. Things can be done about that. An extreme example would be a child who has been abused. I suppose that if a child was simply circumcised as an infant, he would grow up without any problems … but there are later traumas. Possibly if a child was circumcised as an infant and the injury was so traumatic that he buried it in his subconscious, and then the first time he wanted to make love he’d have difficulty. I doubt that that would happen.
R: I have wondered about the way my first son Eric screamed every time his diaper was changed when he was a newborn. This kept up for three weeks. I wonder if it was like operant conditioning. He was circumcised the first time his diaper was ever taken off, so he imprinted on the idea of “pants taken off, this part of me uncovered … pain!!” It took several diaper changes, long after the wound itself had healed, for that behavior to be unlearned.
T: You have a conscious, analytical mind, and a reactive or subconscious mind that controls memory banks. The subconscious is the conditioned response part of the mind, where your habits are. This is where you react without reasoning. If you have been in a car accident, the first time you drive again you react with fear every time somebody comes at you.
R: Circumcision is a form of body alteration. What do you think? Do parents really have the right to alter their children’s bodies in this manner?
T: I wouldn’t assume to alter someone else’s body unless it were needed physiologically. If a baby had a birth defect that could be corrected by cosmetic surgery, I would not hesitate. I suppose if I or my husband had been Jewish we would have had our sons circumcised. I would supersede if my child would be ostracized culturally.
R: It is very hard to question your own culture.
T: I have become increasingly less tolerant of cultural influences. One’s culture has to be a consideration, but parents should give more consideration to this child in present time and what his life is going to be like. If the family is deeply involved in Judaism, went to Temple faithfully, their son would later have a Bar Mitzvah, then I suppose they should have the Bris. But otherwise people should really think about it. I know of one family whose little boy asked to be circumcised at age 6.
R: It was his decision.
T: Yes. If it hurts, it’s not going to affect him traumatically because it was his decision. If any of my boys asks to be circumcised when he gets older, I’ll let him get circumcised.
R: What would you say to parents if it’s after the fact whether they had a traumatic birth, or a Caesarian, or a prolonged separation from the baby, or a circumcision? With all the ideals we’ve been striving for, some parents can feel that they’ve failed.
T: The parents should think in present time. They should give that child a lot of emotional support and love … not anything other than good mothering. If the child has a problem I would encourage him to communicate.
R: With our involvement in home birth and our concern about babies having non-traumatic birth — what are our goals? It is impossible to live in this world without ever feeling pain.
T: The reasons are individualistic, but we should get the baby into this world with as little trauma as possible. Doctors may claim “Well, it’s not that big of a deal. All of us have been born and we’re all just fine!” But there is evidence that how we’re born very definitely affects our emotional and psychological well-being. I have no doubt that severe birth trauma does cause long-term effect. The home birth movement is a commitment to this. Doctors have attacked the home birth movement on medical issues, but they have got to realize that the psychological aspects of birth are every bit as important as the medical ones!
Most parents try to do everything that they believe will be beneficial to their infants and children. As parents we constantly experience guilt, frustration and exasperation as new idea after new idea comes along telling us to do things yet another way. As I write this I can envision other parents in kindred spirit crying “Just when I thought I was doing everything right, somebody comes along telling us that we’ve done something terribly wrong!!”
In 1972 when I was expecting my first child I was full of ideals and philosophies of how I would do everything right when raising my children. Today I have six children. (Now they are all adults.) I recall days when I felt that I was doing my best if I could get everybody into shoes that matched! I have seen many of my ideals “go down the drain,” yet in total perspective, raising children has been a positive experience.
How important is a child’s circumcised or intact penis in perspective of all that will be important in his life? I frequently have found myself caught up in a dilemma of perspective as I have worked on this manuscript, concentrating on traumas inflicted on infants, while meanwhile one or more of my children is crying or needing my immediate attention. What began in part out of personal need to resolve my own remorse over the trauma that my babies suffered has, over the years, grown into an expression of my need for intellectual fulfillment.
The trauma of the circumcision operation and lifelong deprivation of one’s foreskin cannot be denied or dismissed as insignificant. We cannot afford to ignore the importance of events that surround the beginning of life. However, those of us who specialize in birth often tend to become so caught up in the importance of birth related events that we forget that the rest of our children’s lives are equally important. In perspective, I do believe that many other things are more important in a child’s life. I undertook this research in part because I saw a dire need for information on circumcision. Other concerns such as nutrition, breastfeeding, early childhood education, etc. are already being given attention by many other people.
So many factors contribute to the ultimate psychological makeup of an individual, that it is extremely difficult to know how any one isolated event has affected him or her. Despite all of my knowledge, I have no way of knowing how my own sons are affected today by the painful operation that they underwent during infancy. As children they were healthy, usually happy, and seemingly oblivious to their lack of foreskins. Their younger brother, who has been left intact, came along in 1985. Although they all would tease and pester each other as much as any normal siblings, I have never heard the subject of foreskins or lack of same mentioned. Now that my three older sons are adult men, the issue is too painful and personal for me, as their mother, to bring up to them directly, even thought they are well aware of my life work in this field. I have maintained a close, loving and communicative relationship with all of my children in practically all respects, but this issue lies too close to my heart to touch.
“The choice against circumcision will only be relevant if considered within the context of love and acceptance, and of wanting what is best for this child in his life.”
Being wanted, and provided the opportunity to grow up in a happy, loving family are of primary importance in the life of a child. Undoubtedly many little boys who have been abandoned and unwanted have also happened to have intact penises. Therefore, the choice against circumcision will only be relevant if considered within the context of love, acceptance and of wanting what is best for the child in his life.
In the years since this book was originally published, some newer studies have taken place.
In Paul D. Tinari’s study at Kingston General Hospital (Kingston, Ontario, Canada in 1998), infants were strapped into Circumstraints and then placed into an MRI chamber while the lower part of the infant’s body was accessible to the doctor performing the circumcision.
“The baby was kept in the machine for several minutes to generate baseline data of the normal metabolic activity in the brain. This was used to compare the data gathered during and after the surgery. Analysis of the MRI data indicated that the surgery subjected the infant to significant trauma. The greatest changes occurred in the limbic system concentrating in the amigdala and in the frontal and temporal lobes.
“A neurologist who saw the results postulated that the data indicated that circumcision affected most intensely the portions of the victim’s brain associated with reasoning, perception and emotions. Follow up tests on the infant one day, one week and one month after the surgery indicated that the child’s brain never returned to its baseline configuration. In other words, the evidence generated by this research indicated that the brain of the circumcised infant was permanently changed by the surgery.”
(The reactions on the part of the medical system bears witness to the conscious attempt on the part of medical hierarchy to silence all questioning of infant circumcision [aka male genital mutilation]: Upon attempts to publish their findings in the open medical literature – “All of the participants in the research … were called before the hospital discipline committee and were severely reprimanded. We were told that while male circumcision was legal under all circumstances in Canada, according to their dubious interpretation of the ethical regulations, any attempt to study the adverse effects of circumcision was prohibited. Not only could we not publish the results of our research, but we also had to destroy all of our results. If we refused to comply we were all threatened with immediate dismissal and legal action.”)
Paul D. Dinari, Ph.D., Director, Pacific Institute for Advanced Study
(from Circumcision Resource Center, http://www.circumcision.org/brain.htm)
A more recent report by James McIntosh in 2015 (Oxford University, England) shows similar results and has been published in medical media.
“The researchers examined the brains of 10 healthy infants aged 1-6 days old and 10 healthy adults aged 23-36 years. … the babies were placed inside an MRI scanner where the bottoms of their feet were poked with a special retracting rod. …
“The researchers observed significant brain activity in 18 of the 20 brain regions that are active in adults when experiencing pain. The babies’ brains responded in the same way to a poke (force 128mN) as adults did to a stimulus that was four times stronger (512mN).
“Dr. Slater states that their findings stand in contrast with previous understandings of infant pain. ‘In fact, some people have argued that babies’ brains are not developed enough for them to really ‘feel’ pain, any reaction being just a reflex,’ she says. ‘Our study provides the first really strong evidence that this is not the case.'”
McIntosh, James, “World-first MRI Study Shows Babies Experience Pain ‘Like Adults'”, Medical News Today, April 2015, http://www.medicalnewstoday.com/articles/292717.php
“What did the researcher’s find? Eighteen out of the 20 brain regions activated in the adults when experiencing pain were also activated in the infants. This suggests that infants not only feel pain the way adults do, but also that they have a lower pain threshold.”
MRI scans reveal brain activity in response to a painful stimulus in infants and adults.
(These findings were published online in the journal eLife.)
Another study set out to find out whether neonatal circumcision (with and without Emla cream as a numbing agent) altered pain response from vaccinations given at 4 or 6 months in comparison to infants who had not undergone circumcision. Infants were videotaped during vaccination done at the primary care physician’s clinic. Videotapes were scored without knowledge or circumcision or treatment status by a research assistant who had been trained to measure infant facial action, cry duration, and visual analogue scale pain scores. Differences between the groups were assessed in regards to facial action, crying time and assessments of pain. The boys who had been circumcised without any type of anesthesia demonstrated far greater sensitivity to injection pain. Pain reaction from boys for whom the numbing agent had been used during circumcision was somewhat less, while those who had not undergone circumcision demonstrated significantly greater tolerance to the pain of injections.
Taddio, A., et al., “Effect of Neonatal Circumcision on Pain Response During Subsequent Routine Vaccination”, The Lancet, Vol. 349, No. 9052, p. 599-603, March, 1997
Goldman summarizes this by stating: “The authors believe that ‘neonatal circumcision may induce long-lasting changes in infant pain behavior because of alterations in the infant’s central neural processing of painful stimuli.’ They also write that ‘the long-term consequences of surgery done without anaesthesia are likely to include post-traumatic stress as well as pain. It is therefore possible that the greater vaccination response in the infants circumcised without anesthesia may represent an infant analogue of a post-traumatic stress disorder triggered by a traumatic and painful event and re-experienced under similar circumstances of pain during vaccination.'”
Goldman, Ronald, Ph.D., “Infant Responses to Circumcision” (adapted from his book Circumcision: The Hidden Trauma, pages 20-26.) c. 1997. http://www.circumcision.org/response.htm